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Eleventh Circuit: Health Plan's Gender Care Exclusion Does Not Violate Title VII (PDF)

"Anna Lange ... sought a male-to-female sex change surgery and requested that the County's employer-provided health insurance pay for it. But because the County's insurance policy excludes '[d]rugs for sex change surgery' and '[s]ervices and supplies for a sex change and/or the reversal of a sex change,' the insurer denied Lange's request.... Lange then sued the County for disparate treatment because of sex under Title VII of the Civil Rights Act of 1964 ... We took this appeal en banc to answer whether the insurance policy facially violates Title VII. We conclude that it does not." [Lange v. Houston County, Georgia, No. 22-13626 (11th Cir. Sep. 9, 2025)]

Text of Eleventh Circuit Opinion: ERISA Authorizes Claim for Equitable Relief for Alleged Fiduciary Breaches in Plan Enrollment Process (PDF)

"This appeal presents a question of first impression ... Section 1132(a)(3) of ERISA authorizes a beneficiary of an ERISA plan to sue for 'appropriate equitable relief' to redress violations of the plan or statute.... The question for us is: Does Section 1132(a)(3) create a cause of action for an ERISA beneficiary to recover monetary benefits lost due to a fiduciary's breach of fiduciary duty in the plan enrollment process? Our answer is 'yes.' " [Gimeno v. NCHMD, Inc., No. 21-11833 (11th Cir. Jun. 28, 2022)]

Text of Eleventh Circuit Opinion: ERISA's Six-Year Statute of Limitations is Subject to Express Waiver (PDF)

"In particular, this interlocutory appeal requires us to determine whether a defendant is capable of expressly waiving the six-year statute of repose contained in ERISA Section 413(1) -- or whether instead, the protection provided by [that section] is so essential, so fundamental, that it (seemingly almost alone among personal rights) is inherently indefeasible and unwaivable. We won't bury the lede. In response to the district court's certified question, we answer yes -- [that section's] statute of repose is subject to express waiver." [Sec'y, U.S. Dept of Labor v. Preston, No. 17-10833 (11th Cir. Oct. 12, 2017)]

Text of Eleventh Circuit Opinion: Definition of Plan Term Found Only in Extrinsic Documents Does Not Render Plan Document Ambiguous (PDF)

"[B]ecause the Plan defines 'Normal Retirement Date' in reference to Meadowcraft's 'published or accepted personnel practices,' it was necessary for the district court to examine extrinsic evidence of Meadowcraft's personnel practices to determine the Normal Retirement Date. This does not mean the contract was ambiguous. Courts routinely examine extrinsic evidence to determine the meaning of contract terms even while holding that the contract is unambiguous." [Snow v. Boston Mutual Life Ins. Co., No. 13-15067 (11th Cir. Oct. 16, 2014)]

Eleventh Circuit Affirms Summary Judgment for Home Depot on Fiduciary Breach Claims of Excessive Fees and Poor Investment Performance (PDF)

"The plaintiffs say ... that the burden should be flipped, which means ERISA fiduciaries are required to show that their plans' losses were caused by something other than their own failure to investigate and evaluate. In other words, show that the losses were not caused by their breach.... We cannot agree. Our prior precedent forecloses adopting this burden-shifting framework, as do ordinary principles of civil liability. Nor does ERISA's text help the plaintiffs -- it offers no indication that Congress intended to require defendant fiduciaries to disprove loss causation. The plaintiffs thus bore the burden, but they did not sustain it. ERISA requires a prudent process, but it does not guarantee good results." [Pizarro v. Home Depot, No. 22-13643 (11th Cir. Aug. 2, 2024)]

Eleventh Circuit: Healthy Pregnancy Is Not a Pre-Existing Condition for Disability Caused By Stroke (PDF)

"Bradshaw had a healthy pregnancy and no other pre-existing medical conditions when she bought a disability-insurance policy ... [N]ine days after Bradshaw gave birth to her daughter, tragically, Bradshaw suffered a debilitating stroke. So Bradshaw filed a claim for long-term disability benefits with Reliance, which Reliance denied ... because of Bradshaw's healthy pregnancy at the time she purchased her policy; Reliance asserted that qualified as a pre-existing condition that 'contributed to' Bradshaw's stroke.... Reliance's determination was unreasonable. So we reverse and remand the case to the district court for an award of ERISA benefits." [Bradshaw v. Reliance Standard Life Ins. Co., No. 16-11125 (11th Cir. Aug. 31, 2017; unpub.)]

Eleventh Circuit Finds Plan Assignment of Rights Insufficient to Enable Providers to Assert Claims of Fiduciary Breach (PDF)

"The plaintiffs' contention stretches beyond its breaking point the plain meaning of the agreement, which assigns only the right to receive benefits and not the right to assert claims for breach of fiduciary duty or civil penalties. Because the agreements do not support the plaintiffs' position, they lack standing to bring claims under [ERISA Sections] 502(a)(3) and 502(c)." [Sanctuary Surgical Center, Inc., et al. v. Blue Cross and Blue Shield of Florida, Inc., Nos. 13-10635, 13-10636, 13-10667 (11th Cir. Nov. 5, 2013)]

Text of Eleventh Circuit Opinion Upholding Alabama City's Hike in Pension Contributions (PDF)

"Plaintiffs argue that Gadsden firefighters who have complied with the statutory requirements possess a 'vested' right to a 6% employee contribution rate. This argument relies on the assumption that there exists an implied promise not to raise the employee contribution rate once a firefighter becomes eligible for retirement benefits. We can find neither hide nor hair of such a promise.... [T]he City did not alter plaintiffs' pension benefits; instead, it altered their pension obligations. This distinction -- between pension benefits and pension obligations -- is warranted by the well-worn difference between earned and anticipated compensation under the Contract Clause." [Taylor v. City of Gadsden, No. 13-13885 (11th Cir. Sept. 16, 2014)]

Eleventh Circuit: State Medical Malpractice Suit Against HMO Not Preempted by ERISA (PDF)

Land v. CIGNA Healthcare of Florida, No. 02-15549 (11th Cir. Jul. 30, 2003). FindLaw.com excerpt: "Plaintiff"s state law medical malpractice claims against his employment-subscribed health maintenance organization, based upon a mixed decision of eligibility and treatment, are not preempted by ERISA.

WestRock Challenge to Pension Change Dies in 11th Circuit

"Can an employer use [ERISA] to challenge changes made to an underfunded multiemployer pension fund's rehabilitation plan? The U.S. Court of Appeals for the Eleventh Circuit held May 16 that no viable ERISA claim could proceed.... According to the Eleventh Circuit, the disputed rehabilitation plan forced employers to make contributions to address the plan's funding deficiency when they left the plan. This payment was separate from, and in addition to, any withdrawal liability payments the employer was statutorily required to pay, the Eleventh Circuit concluded." [WestRock RKT Co. v. Pace Industry Union-Mgmt. Pension Fund, No. 16-16443 (11th Cir. May 16, 2017)